# COLL COMMUNITY SERVICES LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1700472180
- **Authorized official:** COLLINS KUKWA AYEAH (ADMINISTRATOR)
- **Authorized official phone:** (954) 544-9065

## Contact information

- **Practice address:** 4545 N 67TH AVE UNIT 1109, PHOENIX, AZ 85033-1670
- **Practice address phone:** (954) 544-9065
- **Mailing address:** 4545 N 67TH AVE UNIT 1109, PHOENIX, AZ 85033-1670
- **Mailing address phone:** (954) 544-9065

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 251S00000X | Community/Behavioral Health Agency | — | NULL | — |
| 323P00000X | Psychiatric Residential Treatment Facility | — | NULL | Yes |

## Other

- **Enumeration date:** 12/18/2020
- **Last updated:** 10/02/2024